USE OF GRANULOCYTE-MACROPHAGE COLONY-STIMULATING FACTOR IN 2 CHILDRENTREATED WITH CORD-BLOOD TRANSPLANTATION

Citation
Mr. Vowels et al., USE OF GRANULOCYTE-MACROPHAGE COLONY-STIMULATING FACTOR IN 2 CHILDRENTREATED WITH CORD-BLOOD TRANSPLANTATION, Blood cells, 20(2-3), 1994, pp. 249-255
Citations number
16
Categorie Soggetti
Hematology
Journal title
ISSN journal
03404684
Volume
20
Issue
2-3
Year of publication
1994
Pages
249 - 255
Database
ISI
SICI code
0340-4684(1994)20:2-3<249:UOGCFI>2.0.ZU;2-#
Abstract
Cord blood contains stem cells in amounts similar to or slightly less than those present in a bone marrow collection to be used for bone mar row transplantation (BMT), Too few cord blood transplants (CBT) have y et been performed to define the ability to achieve engraftment and the rate of engraftment, Two cord blood transplants have been performed u sing granulocyte-macrophage colony stimulating factor (GM-CSF) to hast en engraftment, Two children, aged 5 and 6 years received a CBT using HLA-identical stem cells collected at the birth of a sibling, One chil d had X-linked lymphoproliferative disease (XLP), and the other, acute lymphoblastic leukemia in second complete remission, One had an ABO a nd one an Rh blood group mismatch, Conditioning therapy consisted of c yclophosphamide, melphalan, and antithymocyte globulin or busulphan an d cyclophosphamide, Graft-versus-host disease prophylaxis was methotre xate and cyclosporine or cyclosporine, Both children were given GM-CSF at 5 mu g/kg/day from day 1 until the absolute neutrophil count (ANC) reached 1.0 x 10(9)/L for 3 consecutive days, If this level was not r eached by day 14, the dose of GM-CSF was doubled, Both children engraf ted rapidly, with ANCs reaching 0.5 x 10(9)/L in 12 and 16 days, Engra ftment was confirmed by blood group in both and sex chromosome typing in one, Both children developed mild GVHD localized to skin, which res olved with steroid therapy, The child with XLP was cured and has survi ved for 34 months; the second child has survived 27 months with normal marrow function but has had a relapse of leukemia, CBT has been succe ssfully undertaken in young children, Myeloid engraftment occurred at the same rate as that seen in children receiving a BMT followed by GM- CSF.